Can you really use probiotics to fight acne?

Wait, I thought bacteria caused acne… If you’ve ever had a breakout, you’ve likely tried to dry those suckers up with bacteria-killing washes and spot treatments. You know, because conventional wisdom (and lots of research) has shown that zits, particularly the big painful cysts, are often caused by P. acnes bacteria getting into your pores and going to town.

But now bacteria is trying to spin a comeback kid PR campaign, thanks to the rise of probiotics in everything – yoghurts, supplements and now skincare products.

But for those of us who have acne, naturally you’d wonder: Wouldn’t those probiotics just make my skin worse? Luckily, Dr Whitney Bowe, NYC celebrity dermatologist and author of The Beauty of Dirty Skin, is here to lay it all out for you (and me. Because I’m confused too).

First of all, what are probiotics?

While you might automatically associate the word “bacteria” with things like food poisoning and Petri dishes, not all bacteria is bad for you. Enter probiotics, which are live, friendly bacteria that benefit your overall health and your skin. They help you digest food, combat against environmental damage and strengthen the immune system, Dr Bowe says.

Your body naturally contains tons of bacteria (both inside and on your skin) to help it function properly, says Dr Bowe. This is called the microbiome. “There are more than one trillion bacteria in the skin, originating from approximately 1 000 different species,” says Dr Bowe.

Read more: 5 foods high in probiotics (that aren’t yoghurt)

What does this have to do with my skin?

Two things, actually. Inside your body, the bacteria in your gut interact with your immune system, which can affect your skin, Dr Bowe says. “Certain inflammatory skin disorders like acne, rosacea and eczema are thought to flare in those whose gut bacterial mix has been thrown out of balance,” says Dr Bowe.

If your body’s natural balance of bacteria gets thrown out of whack (say you’ve been on antibiotics forever to deal with back-to-back yeast infections), that can damage your intestinal lining. This allows irritating substances that are normally digested to float into your bloodstream, which sets off your immune system and can cause inflammation throughout the body, including redness and skin sensitivity.

Then, remember how Dr Bowe said there’s a bunch of bacteria sitting on top of your skin, too? “If your skin’s healthy microbiome is disrupted by harsh cleansers and other abrasive skin care products, this discontent can result in breakouts,” explains Dr Bowe.

The short version: If your body’s natural bacteria balance inside or outside of the skin gets thrown out of whack, your skin suffers (breakouts, etc). But when your body’s “good” bacteria is healthy and thriving, Dr Bowe says that’s when your skin will look its best.

“As the first line of defence, I tell my patients to try to incorporate foods and drinks that are naturally rich in probiotics, like yoghurt, kombucha, sauerkraut and miso soup,” advises Dr Bowe.

Eat probiotic foods every day in order to see lasting benefits because they pass through your digestive system pretty quickly. And pair them with prebiotics (nondigestible carbs that feed the bacteria, like bananas, onions and garlic) for best results.

If you feel you’re not getting enough probiotics through your diet, then Dr Bowe says a daily supplement is an effective option. “When you’re choosing probiotic supplements, diversity of strains and delivery mechanism are both keys,” says Dr Bowe.

Make sure that the label says there are at least 1 billion CFUs (colony-forming units) and check the strains listed. The more, the merrier! Dr Bowe says these particular strains have been shown to help with acne:

Probiotic foods help your skin from the inside. Probiotic skincare, on the other hand, provides a protective shield from the outside, strengthening your skin barrier to keep your skin hydrated and prevent infection, breakouts and irritation.

Some topical probiotic skin care products contain live cultures to sustain skin’s natural supply of bacteria, while some contain prebiotics. You can get a sense of what strains are in there by reading the ingredient label, although they’re not always listed in the same way that they would be on a supplement label.

3. Avoid bad habits – and foster good ones

Certain skincare products and rituals disturb skin’s good bacteria. “I tell my patients to throw away their loofahs and washcloths and toss all cleansers with the word ‘antibacterial,’” says Dr Bowe. Only use sanitiser when regular soap and water is not available (say, music festival porta potty), she says.

Other lifestyle factors that can help your good bacteria flourish include dialling down stress levels, sleeping well, exercising, taking time to relax and restore, and meditating, says Dr Bowe.

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